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The Bloody Truth About Hematuria: What It Is, What To Look For, What To Do If You Have It

There are many things that can keep one up at night, especially during this time of the year. In urology, one thing that is certainly spooky year round though is the discovery of blood in your urine. This blood is otherwise known as hematuria. Even though it may appear frightening at first, when properly evaluated and diagnosed, hematuria can be very helpful in determining what your physician can do to best treat the problem at hand. Here we hope to outline what hematuria is, what causes it, and how it can best be taken care of in a brief question and answer format to get you back to living life at the fullest.

Question: What is hematuria?

Answer: Hematuria is the abnormal presence of blood in the urine. There are two forms: gross hematuria, when the urine is visibly pink or red and microscopic hematuria, when the urine looks normal but blood is seen under the microscope.

Question: What causes hematuria?

Answer: There are many causes of hematuria. False hematuria is a discoloration of urine from pigments such as food coloring or myoglobin. Fictitious hematuria is the presence of blood cells in the urine from a source outside the urinary such as vaginal bleeding. Kidney disease often causes blood and protein in the urine. The most common causes of significant hematuria are infections, kidney stones, trauma and tumors.

Question: What will the evaluation consist of?

Answer: Once hematuria is identified, a typical evaluation will consist of the following:

  1.     Detailed history and physical
  2.     Urine Specimen to confirm the presence of blood and look for signs of infection
  3.     Urine culture and sensitivity to show if the urine is infected and to determine the specific bacteria and    appropriate antibiotic for treatment
  4.     Blood tests involving a complete blood count (CBC) and a medical profile
  5.     Urine Cytology to evaluate the urine for cancer cells
  6.     IVP (Intraveneus Pyelogram), an x-ray of the urinary tract including kidneys, ureter and bladder
  7.     Cystoscopy-looking into the bladder through a small, telescope-like tube

Question: What is a cystoscopy? 

Answer: A cystoscopy (also known as a cysto for short) is a procedure that helps look inside the bladder and urethra using a telescope. This type of procedure is used to check for cancer of the bladder or urethra, diagnose and evaluate urinary tract disorders, diagnose repeated bladder infections and help determine the cause of pain during urination

Question: How does a cystoscopy work? 

Answer: A cystoscopy is performed with a flexible cystoscope, a special tube with a small camera on the end and the procedure usually takes between 5 – 20 minutes. The urethra is cleansed and the scope is then inserted through the urethra into the bladder. Saline water flows through the cystoscope to fill the bladder, stretching the bladder wall. This allows your health care provider to see the entire bladder wall. You will feel the need to urinate when the bladder is full, however, the bladder must remain full until the exam is completed. If any tissue appears abnormal, a small sample (biopsy) can be taken through the cystoscope to be tested in the lab.

Question: What are treatments options for hematuria and conditions associated with it?

Answer: The proper treatment for hematuria depends on the cause. Hematuria from an infection should be treated with antibiotics while blood in the urine from a kidney stone or tumor will be addressed in a different way. Remember blood in the urine is a sign that should not be ignored. Call to schedule a consult with Dr. Kenneson to find out about all available treatment options at hand today.

Lauren Rogers

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